According to the proposed revision of the DSM the Aspergers diagnosis will be eliminated as a mental disorder. People who meet these criteria will no longer be separated from others on the autism spectrum by this distinction.
This manual for mental disorders is no better than the attitudes and beliefs that influence how it is written and how people use it.
The diagnoses of neurological or psychological disorders has typically been used more to stigmatize and exclude undesirable misfits from society than it has been used to provide support for inclusion.
The physical and neurological aspects of autism are described as damage in a similar way that eugenicist have defined race, sexuality, and any type of oddity as the contamination of the human gene pool. The cultural elite who has an interest in the welfare of large corporations (including the pharmaceutical industry) continue to use bigoted notions as scientific evidence that the current hierarchical power structure cannot and should not be altered.
The autism diagnosis is often not used in accordance with any clear plan of how to better the life of the diagnosed person in the areas that are problematic. Instead it is used to label someone with a list of deficits that support the myths of Western medicine and racial inequality, the defiance of diversity, and the dependence on a governments that waste their most valuable resources.
Encouraging awareness won't reduce autism's stigma, unless there is a better understanding of what stigma is and how it has historically been used.
Wikipedia defines social stigma like this:
Social stigma, a severe social disapproval of personal characteristics or beliefs that are against cultural norms.
Here is the history of autism as it has been defined by the DSM written by Melissa Hincha-Ownby:
The DSM-I
The DSM-I was originally released in 1952. Although autism was recognized as a unique condition as early as 1943, it was not included in the DSM. Instead, children who exhibited autistic-like symptoms were diagnosed under the schizophrenic reaction, childhood type label.
The DSM-II
The second release of the Diagnostics and Statistics Manual of Mental Disorders came in 1968. As with the first release, autism was not included as a separate diagnostic category. In Roy Richard Grinker’s book, Unstrange Minds, the DSM-II included the following language: “the condition may be manifested by autistic, atypical and withdrawn behavior.” Children exhibiting these behaviors were diagnosed as schizophrenic, childhood type.The DSM-III
In 1980, the DSM-III was released and we finally see the inclusion of autism as a separate diagnostic category. At this point, there was only one autism designation and it was entitled infantile autism. There were only six characteristics listed and each of these six symptoms must be present in order for an individual to be diagnosed with infantile autism. Due to some controversy surrounding the descriptor infantile, this category was changed to autistic disorder in 1987.The DSM-IV
The most recent complete release of the DSM, the DSM-IV, occurred in 1994. At this point, the category of pervasive developmental disorders and several subtypes were added. In addition to autistic disorder, a diagnosis could be made under the categories of Asperger’s Disorder, Rett’s Disorder,Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified
All mental illness has traditionally been defined by a single spectrum based on the severity of symptoms. Depression and bipolar disorder are seen as milder forms of mental illness and schizophrenia is seen as the most severe. The treatment for mental illness is based on a person's potential for success in education and a career.
People with less family, less personal confidence, fewer financial resources, fewer friends and social contacts, are perceived as less intelligent. They are labeled as having a bad moral character, being more dangerous and therefore, harder to treat. Conveniently, these "degenerates" (as they are considered) are less likely to argue about the problems with this system in a way that the public sees as worthy of attention. As a result, many abuses go unreported and are justified as necessary.
The ways that levels of functioning are described in mental disorders (which at this point autism is still considered) reminds me of how the tests for competence and intelligence were designed, and what they were designed to do.In this :THE EUGENIC ORIGINS OF IQ TESTING:
IMPLICATIONS FOR POST-ATKINS LITIGATION it says:
"Known as the father of intelligence testing in the United States,
Goddard used a perversion of Binet’s intelligence scale to rank those
he considered feebleminded into varying degrees of mental incompetence:
idiots (pre-verbal), imbeciles (illiterate), and morons (highfunctioning).
For Goddard, morons, or those with mental ages of
eight through twelve, posed the gravest eugenic threat because of
the ease with which they could pass for normal and reproduce. Goddard
found morons wherever he looked: criminals, alcoholics, prostitutes,
and anyone “incapable of adapting themselves to their
environment and living up to the conventions of society or acting sensibly.”
Most immigrants also fit this classification. Goddard tested
immigrants arriving at Ellis Island and found that “[t]he intelligence
.of the average third-class immigrant is low, perhaps of moron
grade.” Goddard concluded that “immigration of recent years is of
a decidedly different character from the early immigration. . . . We are
getting the poorest of each race.”
From views like this of sanity and intelligence have come many of the ideas for how to cure, educate, and behaviorally rehabilitate autistics. This is more a matter of social mores and cultural expectations than any type of scientific or sociological exploration into aiding and empowering more people.
The difficulties we face in modern society with an increasing number of people having mental disorders (for whatever reason that is) are not due to our lack of scientific knowledge of how to accommodate them or alter their behavior. Instead it is our bigoted and dogmatic attitudes that impede scientific knowledge and prevent progress. Cultural attitudes seem to be based more on how to prevent, fix, or ignore whatever or whomever doesn't immediately provide us with what we decide is valuable.
The way the public views autistic people will define how many of us are treated. The treatments that are endorsed for mental disorders and how we encourage diverse expressions will affect everyone.
Accepting autistic people must include the understanding and acceptance of how historical attitudes were designed with exclusive demands for stigmatizing unwanted human traits and ultimately the unwanted people who have them. Neurodiversity isn't just some idealistic notion that requires the balance of needed cures and behavioral therapies for its validity. It is at least a way to re-frame the public's view of autistics in contrast to the over used and quite flawed medical model, so we have more opportunities for a better future.
This is related to a recent award show, NDTV Indian of the Year Icon Award, hosted by NDTV, India's leading news network. Autism/Aspergers is a serious topic journalists cannot be so flippant about. Families and people with this disorder are fighting a tough battle. The anchorperson at the awards show, Ms. Sonya Singh asking the actor Shahrukh Khan to deliver a line from the new blockbuster movie, My Name Is Khan, and then the actor saying "you want me to do the eyes also?", is very insensitive to say the least. The movie, My Name is Khan, is based on a true story of a California resident Mr. Rizwan Khan, who has Aspergers and among other symptoms, he has difficulty with eye contact. What the actor did on awards show, was not a joke that got Ms. Singh and others on the stage laughing. They could have used the moment to increase awareness for neurological disorders, such as the autism spectrum, as would have been appropriate in this case. If they ever wondered why there is a social stigma to mental illnesses, this is the very reason. For his role in Rainman, I can't imagine if Dustin Hoffman or any leading news network in the United States could get away with such reckless behavior, even if it were unintentional. Fame, be it through journalism or entertainment, should come with responsibility.
Posted by: Madhuri Reddy | March 03, 2010 at 06:10 PM